The DSM V, the diagnostic and statistical manual of mental disorders, defines grief as a two-month period where someone could experience clinical depression but would not be diagnosed as such due to the death of their loved one. Clinically speaking, the period in which you can experience extreme sadness without depression or prolonged grief disorder diagnosis is finite. So, that means that after someone we love has died, we could feel depressed all day for two months and not be diagnosed with either of those. But after that, how long might we experience grief without considering it depression or prolonged grief? Amazingly, the DSM-V has added a diagnosis for Prolonged Grief Disorder which they define as intense yearning or longing for the deceased (often with intense sorrow or emotional pain) and preoccupation with thoughts or memories of the deceased (in children and adolescents these thoughts may focus on the circumstances of the death). Additionally, the individual may experience significant distress or problems performing daily activities at home, work, or other important areas. Persistent grief is disabling and affects everyday functioning in a way that typical grieving does not. This diagnosis is only made a year or more after death for adults, and six months or more for children and adolescents. There are other symptoms that I won’t include here.
After those first two months, if we continue to feel depressed all day every day for two weeks or more, that would be diagnosed as depression. Actually, to diagnose clinical depression, one needs 5 of 9 symptoms during that time period. Those symptoms include: depression, anhedonia (lack of interest, motivation, or pleasure), significantly increased or decreased appetite, significantly increased or decreased sleep, low self-esteem, difficulty thinking or concentrating, fatigue, agitation or sluggishness, and/or suicidal thoughts.
In my experience, grief comes in waves, sometimes lasting all day, but often feeling pretty intense for an hour or more. Some days, I might feel grief most of the day, an ache in my chest, a heaviness is my being, and at some point later in the evening, I may need to cry for a while. Surprisingly, grief can also manifest as irritability (often this is covering up your sadness), or agitated energy. Grief can also lodge in the body as physical pain anywhere, but for some the location may be related to the being they are grieving for. I’ve spoken to other mothers who have lost a child who experienced grief in their uterus or ovaries.
I remember the first 3 years after my son died, I had those waves every day. It was something I could almost set my clock by. The ache in my chest would build throughout the day and I might have pain in other parts of my body. At some point, the grief would erupt into tears. Any time that was difficult, EFT (Emotional Freedom Technique) would help to move the energy through my body and help me get the grief out. When you’re experiencing grief, allow yourself time to process your sadness and do something to help yourself feel better. This could be art, exercise, meditation, gardening, EFT, or many other options. The crucial piece is to use one of these (or other) methods to process the grief and get it out of your body, flushing out the emotional or physical pain. Grief not processed can become chronic medical or mental health conditions.
In the next few years, I found that it had changed. I didn’t experience it every day, but still experienced periods of intense grief many days. Now it’s been 8 years since he died and in the last couple of years, other stressors have displaced my grief. Time has given me other, more pertinent things to grieve about. My grief for my son isn’t gone and it may never be gone. I’ll always miss him and there are still days when I need to cry.
Sometimes grief surprises me, impacting me in uncommon ways, at least for me. I may find myself tired, and heavy, and wonder why I feel so low. Eventually, I would explore the possibility that I was feeling grief for my son, and if thinking about him made me cry, I would know that was my answer. If you have a loved one who has died and feel some strange, negative feelings, give yourself some space to explore whether the feelings are caused by grief. Never underestimate the power of grief to manifest in a multitude of ways.
The last couple of days, I have been feeling grief for him, my chest aching, my stomach gurgling, and searching for privacy. I needed to cry. Surprisingly, I didn’t need to cry for very long. My son reached out from beyond the veil to tell me this was good. “You don’t need to feel sad anymore, Mom.” Honestly, he never wanted me to feel sad. I kept telling him that was unrealistic. In the physical world, we feel sadness around loss. It’s normal, natural, and healthier to process the grief than to stuff it inside. Some believe stuffed grief may become cancer, heart disease, or other physical illnesses. We have to consider the mind-body connection.
From my experience, both personal and professional, I think grief is both finite and infinite. In other words, we may experience grief for finite periods, an hour tonight, three hours the next night, barely for a couple of nights, and then all day. These are finite periods of grief. But it also feels infinite, because although it leaves, it always comes back.
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